Provider Demographics
NPI:1093878811
Name:MACABUHAY, MARYLU REYES (MD)
Entity Type:Individual
Prefix:
First Name:MARYLU
Middle Name:REYES
Last Name:MACABUHAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6120 W BELL RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3781
Mailing Address - Country:US
Mailing Address - Phone:602-978-5727
Mailing Address - Fax:602-978-9186
Practice Address - Street 1:6120 W BELL RD
Practice Address - Street 2:SUITE 160
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3781
Practice Address - Country:US
Practice Address - Phone:602-978-5727
Practice Address - Fax:602-978-9186
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ110472080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine